Adverse Reactions to Biologic Medications Used in Allergy and Immunology Diseases

    October 2022 in “ Current Allergy and Asthma Reports
    Timothy Chow, Lauren E. Franzblau, David A. Khan
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    TLDR Biologic therapies can cause various adverse events, but allergy/immunology clinicians can manage them.
    The document reviews adverse reactions to biologic medications used in allergy and immunology, affecting up to 77% of patients starting certain biologics. These reactions are classified into five types and include acute infusion reactions, injection site reactions, cytokine release reactions, and delayed reactions. Diagnostic strategies include skin testing, in vitro tests, anti-drug antibody detection using ELISA and ImmunoCAP assays, and Drug Challenge Testing. The document cites a study involving 95 patients for Drug Challenge Testing, where 47 of the 60 who completed the challenge had no reactions. It also mentions a retrospective study involving 526 desensitizations where 77% completed the Rapid Drug Desensitization procedure without reaction. The document also discusses adverse drug reactions to specific agents, such as Omalizumab, Mepolizumab, Reslizumab, Benralizumab, Dupilumab, Tezepelumab, Rituximab, and Anti-TNF biologics. The document concludes that while biologic therapies have revolutionized treatment, they can cause a spectrum of adverse events, and allergy/immunology clinicians are well-positioned to manage these reactions.
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